Relationship between Late Gadolinium Enhancement Extent in Cardiac Magnetic Resonance Imaging and Severity of Coronary Artery Disease in Old Myocardial Infarction

Purpose: To assess the relationship between the severity of coronary arteries involvement and the extent and pattern of myocardial scars in Cardiac Magnetic Resonance of patients with history of remote myocardial infarction. Materials and Methods: The Cardiac Magnetic Resonance images of sixty patients with history of remote ST segment or non-ST segment elevation myocardial infarction were reviewed. The patients were candidates for selective coronary angiography and referred for Cardiac Magnetic Resonance imaging in order to evaluate the myocardial viability. Results: The age of patients with history of old myocardial infarction (n = 60), among whom 78.3% were male, averaged 61.2 (SD = 11.5). There was no association between the severity of coronary artery stenosis in each territory and the presence of myocardial scar detected by late Gadolinium enhancement of Cardiac Magnetic Resonance (for all three vessel territories P = .05). However, there was a significant association between the coronary artery runoff and the presence of late Gadolinium enhancement in Cardiac Magnetic Resonance (P value for left anterior descending coronary artery [LAD], left circumflex [LCX] and right coronary artery [RCA] was = .002, = .001 and = .001, respectively). A significant relationship was found between the pattern of scar in terms of being transmural or non-transmural and the severity of coronary artery stenosis (P = .001), while the pattern of scar was not associated with the coronary artery runoff (P = .2). Conclusion: The results of this study support the hypothesis contending that the time window for revascularization will increase in the presence of antegrade coronary flow in the jeopardized myocardium, which causes a limitation in the infarct progression and subsequent lesser extent of myocardial scar